Metformin improves blood glucose levels and BMI in very obese children

First line diabetes drug shown to be safe and effective in
children at risk for type 2 diabetes
Chevy Chase, MD ––Metformin therapy has a beneficial
treatment effect over placebo in improving body mass index (BMI)
and fasting glucose levels in obese children, according to a recent
study accepted for publication in The Endocrine Society's Journal
of Clinical Endocrinology & Metabolism (JCEM). The study showed
reduction in BMI was sustained for six months.

Childhood obesity has increased globally over the last two
decades and it is linked to an increase in the diagnosis of type 2
diabetes in childhood, previously a condition that was only
diagnosed in adults. Metformin is a first line drug for type 2
diabetes, and has been used for many decades. In adults metformin
delays the onset of type 2 diabetes, but there is no evidence that
the drug has a similar effect on children.

"Our findings provide evidence that a treatment course of
metformin is clinically useful, safe and well-tolerated in obese
children who are at risk for type 2 diabetes," said Deborah
Kendall, MD, of Royal Manchester Children's Hospital in the United
Kingdom and lead author of the study. "Metformin may also provide
stimulus for lifestyle changes and potentially reduce long-term
risk for type 2 diabetes and its associated health problems."

This prospective, randomized, double-blind, placebo-controlled
trial was conducted at six pediatric endocrine centers in the
United Kingdom and involved 151 obese children and young people
with hyperinsulinemia and/or impaired fasting glucose or impaired
glucose tolerance. Study participants received either metformin or
placebo daily for six months. This trial is the largest of its kind
to focus on metformin in obese non-diabetic children and young
people.

"Our results show that metformin can improve BMI and blood
glucose levels in obese children, but longer term effects such as
reduction in the incidence of type 2 diabetes need further study,"
noted Kendall.

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Other researchers working on the study include: R. Amin, F. Ivison,
A. McGovern, L. Tetlow, P. Clayton and C. Hall of Royal Manchester
Children's Hospital; T. Barrett of Birmingham Children's Hospital,
UK; P. Dimitri, J. Wales and N. Wright of the University of
Sheffield, UK; M. Kibirige of The James Cook University Hospital,
UK; V. Mathew of Hull Royal Infirmary, UK; K. Matyka and H.
Stirling of University Hospital Coventry and Warwickshire National
Health Service Trust, UK; and A. Vail of the Centre of
Biostatistics, UK.

The article, "Metformin in Obese Children and Adolescents: The
MOCA Trial," appears in the January 2013 issue of JCEM.

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